Berrin Acar

The effect of exercise on physical fitness and quality of life in postmenopausal women.

OBJECTIVES This study was designed to determine the effect of exercise on the physical fitness level and quality of life in postmenopausal women. 81 volunteer postmenopausal women who entered the menopause naturally and have been taking hormone replacement treatment (HRT) were divided randomly into two groups: exercise (n=41) and control (n=40). METHODS Physical fitness tests and the Nottingham Health Profile (NHP) were used to assess physical fitness and quality of life in both groups, both before and after 6 weeks. The study group participated in an exercise programme, which was composed of sub-maximal aerobic exercises for a 6-week period 3 times a week. The statistical analyses were done by paired samples t-test and independent samples t-test. RESULTS At the end of 6 weeks exercise period, when the two groups were compared after the exercise period, we found statistically significant differences in strength, endurance, flexibility and balance parameters in the exercise group (P<0.05). There was also a statistically significant change in the exercise group for the NHP indicating an improvement in the quality of life (P<0.05). CONCLUSIONS In this study, it was concluded that the fitness level and quality of life on postmenopausal women could be improved by a regular and controlled exercise programme of 6 weeks.

Plasma copper, zinc and magnesium levels in patients with premenstrual tension syndrome

We measured plasma Cu, Zn and Mg levels in 40 women suffering from premenstrual tension syndrome (PMTS) and in 20 control subjects by atomic absorption spectrophotometer. Mean plasma Cu. Zn and Mg levels, the Zn/Cu ratio were 80.2±6.00 μg/dl, 112.6 ±8.35 μg/dl, 0.70±0.18mmol/1, and 1.40± 0.10 in the PMTS group; and 77.0±4.50 μg/dl. 117.4 ±9.50 μg/dl. 0.87±0.10 mmol/l, and 1.51 ±0.05 in the control group respectively. The mean Mg level and the Zn/Cu ratio were significantly lower in PMTS patients than in the control group. Plasma Mg and Zn levels were diminished significantly during the luteal phase compared to the follicular phase in PMTS group. Mg deficiency may play a role in the etiology of PMTS.

Diminished growth hormone responses to l-Dopa in polycystic ovarian disease

OBJECTIVE To investigate the GH secretion capacity in polycystic ovarian syndrome (PCOS). DESIGN Prospective. SETTING Reproductive endocrinology unit. PATIENTS Nineteen women with clinical and endocrinologic signs of PCOS were compared with 10 healthy weight-matched volunteers with normal menstrual rhythm and no history of endocrine or reproductive abnormality. INTERVENTIONS Standard GH reserve estimates were affected in all subjects using oral L-Dopa. The test was carried out after an overnight fast on cycle days 5 to 8 in menstruating subjects; the test was done randomly in patients with amenorrhea. RESULTS Both PCOS and control groups responded to L-Dopa over a 3-hour period with significant elevations in GH concentrations. The control group showed significantly higher values than the PCOS group at 90, 120, and 180 minutes. CONCLUSION The findings indicate that PCOS patients demonstrate a relative deficiency in GH reserve.

Comparative evaluation of serum levels of main minerals and postmenopausal osteoporosis

OBJECTIVE The purpose of this study was to determine the relationship between serum main minerals and postmenopausal osteoporosis. STUDY DESIGN A total of 728 postmenopausal women were included in this study. Women were separated into two groups according to presence or absence of osteoporosis (OP). BMD was measured in total femur (TF), femoral neck (FN) and lumbar spine (L1-L4) by dual-energy X-ray absorptiometry. Risk factors for OP were recorded by using a structured questionnaire. MAIN OUTCOME MEASURES Womens blood were collected and serum concentrations of iron, copper, zinc, sodium, potassium, magnesium, calcium, ionized calcium, inorganic phosphorus were measured. RESULTS Low serum copper levels were significantly associated with OP according to BMD values for TF, FN and L1-L4. There was a significant relationship between low serum zinc levels and OP for L1-L4 spines. Low iron serum levels were also significantly associated with OP in BMD measurements of TF. Low serum magnesium levels had significant association with OP of L1-L4 spines and TF. Serum levels of calcium, ionized calcium, potassium, sodium and inorganic phosphorus were not associated with OP. CONCLUSIONS In postmenopausal women, the low serum levels of copper, zinc, iron and magnesium appear to be an important risk factor for OP.

Role of kisspeptin in polycystic ovary syndrome (PCOS)

Abstract Objective: Due to the complex relationship between kisspeptin and the hypothalamic-pituitary-gonadal axis, the study was planned to measure the kisspeptin levels in polycystic ovary syndrome (PCOS) and to analyze the correlations between kisspeptin and PCOS-related reproductive, metabolic changes. Methods: The study was designed as a prospective study in Dokuz Eylul University between December 2011 and September 2013. A total of 285 PCOS cases and 162 controls were recruited. After the antropometric measeruments and physcial examination, blood samples were taken for biochemical analysis. Results: PCOS group’s mean BMI was 24.32 ± 3.40 and for the control group, BMI value was 23.44 kg/m2 ± 4.08 (p = 0.351). PCOS patients’ FSH level was 5.10 ± 2.01 mIU/L, LH value was 7.75 ± 4.31 mIU/mL, LH/FSH ratio was 1.70 ± 1.28, DHEAS value was 221.84 ± 105.02 mg/dl, total testosterone value was 50.51 ± 27.93 ng/ml, free testosterone value was 2.52 ± 1.05 pg/ml, SHBG was 63.74 ± 45.62 nmol/L, LDL was 102.56 ± 23.45 mg/dL, HDL value was 51.36 ± 12.15 mg/dL, total cholesterol value was 214.85 ± 39.27 mg/dL, triglyceride value was 112.95 ± 46.88 mg/dL, Apo A1 value was 171.30 ± 35.35 mg/dL, Apo B value was 71.08 ± 19.07 mg/dL, Apo B/A1 ratio was 0.42 ± 0.14, free androgen index was 13.77 ± 14.15, fasting glucose value was 80.68 ± 13.80 mg/dL, fasting insulin levels was 14.13 ± 9.11 μiU/mL, HOMA-IR index was 2.76 ± 2.34, AMH value was 5.93 ± 3:33 in ng/ml, and found to be significantly higher (p < 0.001). Leptin value was 9.71 ± 5.54 pg/ml and kisspeptin value was 1.92 ± 1.29 ng/ml, respectively. Kisspeptin and leptin levels showed no statistically significant difference with control group and PCOS group. In all PCOS patients, kisspeptin showed positive correlations between LH and leptin levels. Conclusion: In this study, kisspeptin had a positive correlation with LH and leptin levels in PCOS. In fact, the serum levels of kisspeptin and leptin does not differ statistically between PCOS and healthy women. There are limited data in the literature with regard to changes in kisspeptin levels and its relation with metabolic and hormonal disturbances.

Piperacillin alone vs triple antibiotic combination in gynecological infections.

Forty hospitalized adult patients with gynecological infections were randomly assigned to treatment either with piperacillin alone (22 patients) or with the combination of gentamicin, clindamycin and penicillin G (18 patients). The aim of the study was to investigate the possibility of replacing a triple combination therapy with a single-agent broad spectrum antibiotic. Penicillin G was added for the coverage of enterococci. The median duration of treatment was 8 days for both groups. The daily dose for the administered drugs was 12g for piperacillin, 4mg/kg for gentamicin, 1.8g for clindamycin and 20 million units for penicillin G. The cure-improvement rate in the single agent therapy group was 90.9% and in the combination therapy group 94.4%. These differences were not statistically significant. No side effects were reported. It is concluded that single agent piperacillin is as effective as the combination therapy used in this study for the treatment of hospitalized gynecological infections.

Evaluation of thyroid function status among postmenopausal women with and without osteoporosis

To investigate the relationship between thyroid function status and bone mineral density (BMD) among women with postmenopausal osteoporosis.

Rare gynecological condition causing sciatic pain

A 59-year-old women admitted to hospital with complaints of pain radiating from the low back and back of the right leg to the toes, numbness and inability to walk due to pain. She was referred to the neurosurgery department with a tentative diagnosis of herniated lumbar disc. On neurological examination, the patient was unable to bring her right foot to a completely neutral position in dorsiflexion and big toe dorsiflexion was 415 of its motor capacity, with hypoesthesia in the L4, Ls, S,, SZ, dermatomes, femoral extension test and Laseques’s sign were also positive on the right leg. The patient stated that the intrathecal pressure raising maneuvers as coughing and sneezing did not aggravate the pain. X-ray of abdomen and lumbosacral region revealed a 3 x 3 cm opacity at the right side of the pelvis (Fig. 1). Myelography and computed tomography (CT) did not reveal any particular pathology. The patient was referred to gynecology department for further evaluation of the pelvic opacity. On gynecological examination, a 3 x 3 cm in size solid mass in the upper right part of the uterus was detected. This was suspected to be a calcified subserous myoma or an -ovarian tumor. On laparatomy, uterus was observed in normal postmenapausal size, with a calcified myoma, 3 x 3 cm in dimensions, being found in the upper right portion of the uterus. Pathological examination following total abdominal hysterectomy and oophorectomy revealed calcified degenerated myoma. Immediately after the operation the patient was free from all complaints and the pathological signs, observed on the day of admission. The im-

Investigation of the fluidity of biological fluids with a PDDTBN spin probe

Abstract The aim of this study is to ascertain whether the electron spin resonance technique using perdeutero-di- t -butyl nitroxide (PDDTBN) as a spin probe is able to monitor relative fluidity changes occurring in body fluids, such as blood and parotid saliva, according to different physiological conditions. The present study reveals that the spin probe PDDTBN is able to monitor the fluidity changes in parotid saliva related to habitual smoking, and in whole blood related to the estradiol level. The rotational correlation time of the spin probe and the local viscosity values of the parotid saliva and blood have been reported.

DIAGNOSTIC VALUE OF MAGNETIC RESONANCE IMAGING IN GYNAECOLOGY

EDITORIAL COMMENT: We accepted this paper for publication because we thought readers would be interested to know of the diagnostic accuracy of magnetic resonance imaging in gynaecology. It should not be overlooked that patients with a palpable mass in the pelvis almost always need a laparotomy once the general condition has been assessed and chest radiography performed to exclude multiple metastases i.e. in most cases investigations do not alter management. This statement applies to ultrasonography, radiography and magnetic resonance imaging. Often it is wise to do a barium enema in a patient with a pelvic mass mainly to establish whether the condition is a general surgical or a gynaecological problem but the fact of the matter is masses do not go away without surgery and deferring of surgery by investigation is not helpful to the patients prognosis.